A compassion-based treatment for couples with the female partner suffering from current depressive disorder: A randomized-controlled trial.

BACKGROUND: Studies have shown that depression and interpersonal relationships are interdependently connected and that including the intimate partner in treatment for depression has beneficial effects. Given evidence that compassion is both an interpersonal quality and a promising treatment target, the goal of this study was to examine the effects of a compassion-based, contemplative treatment for couples employing a multi-method approach for evaluation. METHODS: In a pre-post-follow-up design, n = 53 different-sex couples including women with current depression were randomly assigned to a 10-week-long CBCT®-fC (Cognitively-Based Compassion Training/intervention for couples) or treatment-as-usual (TAU) condition. Multi-level linear regression models and post-hoc contrasts were calculated to determine changes in depressive symptoms, mindfulness and self-compassion, interpersonal functioning and neuroendocrine markers collected during a partnership appreciation task (PAT) in the laboratory before and after CBCT-fC treatment. RESULTS: While CBCT-fC led to a comparable decrease of depressive symptoms as TAU, the training specifically increased self-compassion and mindfulness versus TAU. Interestingly, interpersonal functioning did not improve, which was also reflected in participants' preferred self-focus in-between-session practices, instead of practices with interpersonal focus. There were no group-specific changes in psychobiological stress-marker reactivity. CONCLUSIONS: CBCT-fC was effective in decreasing current depressive symptomatology and increasing mindfulness, and self-compassion. Especially the motivation to participate, such as improving interpersonal functioning, should be addressed and intrinsic motives of the partners to be involved. In highly burdened individuals, self-regulation may need to be improved before co-regulation can be addressed, which would requiring longer treatments. Facilitating factors for engaging in the practice between-sessions seem meaningful.

Effects of a mindfulness-based intervention on mindfulness, stress, salivary alpha-amylase and cortisol in everyday life.

A large body of literature has shown the effectiveness of mindfulness-based interventions (MBI) on stress-reduction. However, little is known about their effects on psychobiological stress-markers in daily life through an ecological momentary assessment approach. Our study examines the effects of MBI on state mindfulness, perceived stress, and indicators of sympathetic-nervous-system (saliva alpha-amylase, sAA) and hypothalamic-pituitary-adrenal-axis (saliva cortisol, sCort) activation in daily life. Twenty-eight individuals participated in a three-month MBI (IG) and were compared to 46 controls (CG). An ecological momentary assessment (EMA) was used to assess mindfulness, stress, sAA and sCort at six measurements per day on two days each before and after the MBI. Multilevel-modeling was used to analyze the data on a moment-to-moment and averaged day-level. The IG showed decreased sAA levels (AUCg) from pre to post, while the CG showed increases. Furthermore, diurnal decreases in sCort (AUCi) were pronounced in the IG compared to the CG. On a momentary basis, mindfulness was associated with lower stress and sAA levels, but not sCort. As such, we show that MBI can reduce sympathetic and to a lesser extent hypothalamic-pituitary-adrenal activation in daily life. Increased mindfulness can momentarily decrease stress and stress-related autonomic activation with implications for health. Our results emphasize the importance of brief interventions that can be easily integrated into everyday life.

Mindfulness-Based Couple Interventions: A Systematic Literature Review.

Over the past decades, mindfulness-based interventions have been shown to improve individual health and well-being in clinical and nonclinical settings. More recently, secular contemplative trainings were adapted to the couple context as research showed satisfying couple relationships to be one of the strongest predictors of physical and mental health. Mindfulness-based interventions hence seem to be a promising treatment in couple counseling and therapy in both clinical and nonclinical settings. Therefore, we conducted a systematic review to provide an overview of the emerging literature in the field of mindfulness-based interventions for couples and other dyads. Overall, sixteen studies met the inclusion criteria. To summarize the heterogeneous quantitative literature regarding individual outcomes, mindfulness interventions for couples seem to increase mindfulness, self-compassion, well-being, and quality of life. Additionally, we found initial evidence of beneficial effects on relieving psychopathological symptoms and psychobiological stress measures. Measures of relationship quality were the predominant dyadic outcome. Based on these studies, we cautiously conclude that mindfulness trainings can enhance relationship quality. Practitioners should be aware that mindfulness-based interventions for couples can potentially improve the perceived relationship quality between partners and the individual burden. Future studies should expand the field, particularly with regard to other contemplative practices for couples such as compassion interventions.

Durante las últimas décadas, se ha demostrado que las intervenciones basadas en la conciencia plena mejoran la salud y el bienestar en entornos clínicos y no clínicos. Recientemente, se adaptaron capacitaciones contemplativas seculares al contexto de la pareja, ya que las investigaciones demostraron que las relaciones satisfactorias de pareja son uno de los predictores más firmes de la salud mental y física. Por consiguiente, las intervenciones basadas en la conciencia plena parecen ser un tratamiento prometedor en la terapia de pareja, tanto en entornos clínicos como no clínicos. Por lo tanto, realizamos un análisis sistemático para ofrecer una descripción general de las publicaciones que han surgido en el ámbito de las intervenciones basadas en la conciencia plena para parejas y otras díadas. En general, dieciséis estudios cumplieron con los criterios de inclusión. Para resumir las publicaciones cuantitativas heterogéneas con respecto a los resultados individuales, las intervenciones de conciencia plena para parejas parecen aumentar la conciencia, la autocompasión, el bienestar y la calidad de vida. Además, descubrimos pruebas iniciales de efectos beneficiosos en el alivio de los síntomas psicopatológicos y en las valoraciones de estrés psicobiológico. Las valoraciones de la calidad de la relación fueron el resultado diádico predominante. Sobre la base de estos estudios, llegamos prudentemente a la conclusión de que las capacitaciones en conciencia plena pueden mejorar la calidad de la relación. Los profesionales deben estar al tanto de que las intervenciones para parejas basadas en la conciencia plena pueden mejorar la calidad de la relación percibida entre los integrantes de la pareja y el agobio individual. Los estudios futuros deben ampliar el ámbito, particularmente con respecto a otras prácticas contemplativas para parejas, como las intervenciones centradas en la compasión.

Stress-reducing effects of a brief mindfulness intervention in palliative care: Results from a randomised, crossover study.

OBJECTIVE: Mindfulness-based interventions are a widely used and highly accepted adjunct treatment in oncology. Due to a paucity of research in advanced cancer and other terminal illnesses, we aimed to evaluate the stress-reducing effects of a brief, standardised mindfulness intervention for use in palliative care. METHODS: This study was a randomised, crossover trial where patients participated in both a single mindfulness intervention and a resting state control condition. The order of the conditions was randomised. Study outcomes encompassed self-report data on stress and well-being and measures of heart rate variability. All outcome data were measured at four times per day. RESULTS: Forty-two patients participated in this study. We found significantly stronger reductions in self-rated stress and mean heart rate as well as an increase in heart rate variability after the mindfulness intervention. Psychophysiological effects were strongest in the immediate pre- to post-intervention comparison, while the effect on subjective stress persisted after 20 to 40 min. No significant differences were found for self-rated well-being. CONCLUSIONS: Despite the rather small magnitude of effects, the brief mindfulness intervention showed to be effective and accepted by patients in very advanced stages of a disease and could be offered by trained healthcare professionals in palliative care.

Psychosocial Interventions for Pain Management in Advanced Cancer Patients: a Systematic Review and Meta-analysis.

PURPOSE OF REVIEW: This systematic review and meta-analysis aimed to synthesize the evidence on the effects of psychosocial interventions on pain in advanced cancer patients. RECENT FINDINGS: The included studies investigated the effects of relaxation techniques, cognitive-behavioral therapy, music therapy, mindfulness- and acceptance-based interventions, and supportive-expressive group therapy. Overall, we found a small, but significant effect on pain intensity (d = - 0.29, CI = - 0.54 to - 0.05). Effect sizes were highly heterogeneous between studies. We did not find evidence for the superiority of any of the intervention types. However, psychosocial interventions may be more effective if they specifically targeted pain distress as the primary outcome. Although findings were mixed, psychosocial interventions can be recommended to complement comprehensive care to alleviate pain in patients facing an advanced or terminal stage of the disease. Future research should develop innovative interventions tailored specifically for pain relief.